Chronic obstructive pulmonary disease and comorbid hypertension: assessment of systemic inflammation and endothelial dysfunction

This study was aimed at determination relationships between systemic inflammation and endothelial dysfunction biomarkers and different cardiovascular and respiratory parameters in patients with chronic obstructive pulmonary disease (COPD) and comorbid hypertension.

Methods. Sixty five patients (50 males, 15 females) with stage 1–4 COPD and hypertension of different severity were involved in the study.

Results. High levels of inflammation and endothelial dysfunction biomarkers (hsCRP, sICAM1, endothelin1, and sPselectin) were found in patients with COPD and hyper tension. Statistically significant relationships were found between inflammatory biomarkers and endothelial dysfunction biomarkers and between biomarkers and different cardiovascular and respiratory parameters in patients with COPD and comorbid hypertension.

Conclusion. Inflammation and endothelial dysfunction biomarker levels change according to increasing in systemic arterial pressure and worsening of bronchial obstruction. This relationship should be considered while examining patients with COPD and comorbid hypertension.

1. Mannino D.M., Ford E.S., Red S.C. Obstructive anrrestric tive lung disease and markers of inflammation: data from the Third National Health and Nutrition Examination. Am. J. Med. 2003; 114: 758–762.

2. Schneider K.M., O’Donnell B.E., Dean D. Prevalence of multiple chronic conditions in the United States’ Medicare population. Health Qual. Life Outcomes. 2009; 7: 82.

3. Sin D.D., Man S.F. Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation. 2003; 107: 1514–1519.

4. Zadionchenko V.S. Hypertension and chronic obstructive pulmonary disease: clinical and pathological parallels and therapeutic approach. Rossiyskiy kardiologicheskiy zhurnal. 2009; 6: 62–69 (in Russian).

5. Karoli N.A., Rebrov A.P. Comorbidity in patients with chronic obstructive pulmonary disease: a role of cardiovascular disease. Ratsional'naya farmakoterapiya v kardiologii. 1999; 4: 9–16 (in Russian).

6. Anthonisen N.R., Connett J.E., Enright P.L., Manfreda J. Hospitalizations and mortality in the Lung Health Study. Am. J. Respir. Crit. Care Med. 2002; 166: 333–339.

7. Suylen R.I., Smits J.F., Daemen M.J. Pulmonary artery remodeling difference in hypoxia and monocrotaline induced pulmonary hypertension. Am. J. Respir. Erit. Care Med. 2008; 157: 1423–1428.

8. Heitzer T., Schlinzig T., Krohn K. et al. Endothelial dysfunction, oxidative stress and risk of cardiovascular events in patients with coronary disease. Circulation. 2001; 104: 263–268.

9. Lucher T.F., Noll G. The pathogenesis of cardiovascular disease: role of the endothelium as a target and mediator. Atherosclerosis. 1995; 118: 81–90.

10. Nosratola D., Bernardo R. Mechanisms of disease: oxidative stress and inflammation in the pathogenesis of hypertension. Nat. Clin. Pract. Nephrol. 2006; 2 (10): 582–593.

11. Repine J.E., Bast A., Lankhorst L. Oxidative stress in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1997; 156: 341–357.

12. Henning B., Diana J.N., Toborek M., McClain C.J. Influence of nutrients and cytokines on endothelial cell metabolism. J. Am. Coll. Nutr. 1994; 13: 224–231.

13. Constans J., Conri C. Circulating markers of endothelial function in cardiovascular disease. Clin. Chim. Acta. 2006; 368: 33–47.

14. Corrado E., Rizzo M., Tantillo R. et al. Markers of inflammation and infection influence the outcome of patients with baseline asymptomatic carotid lesions: a 5year followup study. Stroke. 2006; 37: 482–486.

15. Ridker P.M., Haughie P. Prospective studies of Creactive protein as a risk factor for cardiovascular disease. J. Invest. Med. 1998; 46: 391–395.

16. Ridker P.M., Hennekens C.H. Creactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N. Engl. J. Med. 2000; 342: 836–843.

17. Saetta M., Baraldo S., Corbino L. et al. CD8+ve cells in the lungs of smokers with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1999; 160: 711–717.

18. Beatrice B., Ralph С., Caveh M. et al. Mediates increased neutrophil and macrophage adhesiveness to alveolar epithelial cells. Am. J. Respir. Cell. Mol. Biol. 2001; 25 (6): 780–787.

19. Voronkova O.O. Proinflammatory cytokines and nonspecific inflammatory biomarkers in patients with COPD and change under the treatment: Diss. Moscow; 2006 (in Russian).

20. Ol'binskaya L.I., Tsvetkova O.A., Voronkova O.O. Activity of proinflammatory cytokines in COPD patients. In: Actual Issues of Internal Medicine. Moscow: Russkiy vrach; 2003: 198–205 (in Russian).